Pandemic-related healthcare disruptions, including missed or delayed appointments and procedures, led to an increase in potentially preventable hospitalizations for patients, according to a study yesterday in the British Medical Journal.
This is the first study to assess COVID-related health disruptions on a patient level, the authors said.
Study involved almost 30,000 people
The authors identified avoidable emergency hospital admissions by analyzing data from seven longitudinal studies in the UK Longitudinal Linkage Collaboration (UK LLC) with linked data for 29,276 people in England to their NHS electronic health records from March 1, 2020, to August 25, 2022.
Avoidable hospital admissions were those defined as conditions that should have been first treated through community care, and not ambulatory care. A number of medical codes and search items were used to identify such conditions.
Out of the 29,276 participants, 9,742 (33%, which the authors adjusted to 35%) reported disrupted access to healthcare during COVID-19. Twenty-six percent of participants said they had trouble accessing appointments, and 18% said they experienced delayed scheduling of procedures. Six percent said they experienced disruption in their access to drugs.
"Participants who experienced some form of disrupted access to healthcare were older, had poorer health, and were more likely to live in the most deprived areas," the authors said.
80% higher odds of being hospitalized
If a person reported a disruption to healthcare access, they had an 80% increased risk of being hospitalized for any health condition (odds ratio [OR] 1.80; 95% confidence interval [CI], 1.39 to 2.3).
Treatment and surgeries are less easy to deliver safely during a pandemic.
For acute medical problems, the OR was 2.01 (95% CI, 1.39 to 2.92), and for chronic health conditions the OR was 1.80 (95% CI, 1.31 to 2.48).
If the disruption took the form of disrupted access to procedures, the patient had 77% higher odds of being admitted to hospital for any ambulatory care–sensitive condition (OR 1.77; 95% CI, 1.30 to 2.41), 45% higher odds of an emergency urgent care–sensitive admission (OR 1.45; 95% CI, 1.05 to 1.99), and 57% higher odds of any hospital admission.
People who experienced disruption in accessing appointments had a 46% higher risk of any hospital admission (OR 1.46; 95% CI, 1.21 to 1.75), the authors said.
"Our finding on disrupted access to procedures being associated with avoidable hospital admissions is intuitive," the authors concluded. "Treatment and surgeries are less easy to deliver safely during a pandemic, whereas consultations and access to drugs can be provided remotely, especially given the opportunities of online working."
